Not Just “COVID Anxiety”: A Case of Subacute Thyroiditis in a Patient Recovering From SARS-CoV-2 Infection

Abstract

Subacute thyroiditis (SAT) is an uncommon, granulomatous, inflammatory thyroid disorder. It usually presents with anterior neck and/or jaw pain, diffusely tender goiter, fever, fatigue, myalgia, and anorexia. Most patients with SAT initially develop symptoms and signs of hyperthyroidism which usually subsides within a few weeks with or without going through a transient phase of hypothyroidism. SAT is usually associated with a viral infection of the upper respiratory tract. We report a case of SAT in a 30-year-old male with a recent COVID-19 infection. The patient presented with a three days history of painful anterior neck mass and palpitations. He was diagnosed with COVID-19 16 days before presentation. His infection was mild and did not need any treatment apart from as-needed paracetamol. The patient was found to have a clinical, laboratory, and imaging findings consistent with SAT. The patient was prescribed ibuprofen, prednisone, and propranolol. The patient showed significant clinical and biochemical improvement on follow-up visits, achieving a euthyroid state within several weeks. Like many other respiratory viral illnesses, COVID-19 also seems to be associated with SAT. Other endocrinological sequelae have also been reported. While reviewing patients suffering from COVID-19 infection, these possibilities should be kept in mind.